The emergence of maternal-fetal conflict policies

George Washington University Medical Center's Policy on decisionmaking by pregnant patients is being widely circulated by the ACLU; copies of the Policy can be obtained by calling the American Civil Liberties Union Reproductive Freedom Project. There is, of course, much disagreement over the details of the Policy; not everyone will agree with its underlying philosophy favoring maternal rights. Nevertheless, there does seem to be a consensus that wherever possible these conflicts should be resolved in accordance with previously adopted policies rather than by the courts on an ad hoc basis. Had the Policy been in place in 1987, the Carder case would probably not have been submitted to a judge in the first place, nor would Angela Carder have been forced to undergo a Caesarean section. All hospitals should consider adopting a maternal-fetal conflict policy, and those that do so should be aware of the George Washington University Medical Center Policy, whether or not they agree with its provisions. Whatever policy each hospital ultimately develops should be integrated with decisionmaking and informed consent policies already in place. The formulation and implementation of such a policy, reflecting the hospital's legal and ethical obligations to its pregnant patients, will go a long way towards preventing unnecessary resort to the courts.     

Competition in political and economic markets

Prepared as a response to Frey and Eichenberger's Anomalies in Political Economy. We thank Gordon Tullock for helpful discussions. This work was partially supported by the Taylor Experimental Laboratory at Washington University.     

Elections and government spending

It is widely believed that electoral pressures cause legislators to favor government spending programs. This electoral theory of spending is shown to encompass two core hypotheses: (1) the electoral consequences hypothesis, which states that support for spending programs improves the representative's electoral showing; and (2) the legislator insecurity hypothesis, which states that greater electoral insecurity leads representatives to be more in favor of spending programs. A test of these ideas using spending scores for U.S. representatives in 1986 finds that neither hypothesis is supported by the data.     

Last rights. In sickness and in health, more people are taking life's biggest decision away from doctors and into their own hands

When dying is all that awaits them, more and more people are choosing certain death now rather than uncertain life on medical support systems. But the decision seldom comes easy, as a Newsweek reporter discovers during three weeks with the doctors, nurses, patients and families in an intensive-care ward. A best-selling guide to suicide fires debate over when it is right to let life go--and who should make that choice when the patient no longer can.